Dr. Zorba Paster: keep travelers’ diarrhea at bay

No matter what slang term you give it, travelers’ diarrhea is the pits.

It’s a trip spoiled. Most of us who have traveled internationally know what I’m talking about.

My worst case was in India. Picture this: My wife, Penny, and I were trampling around the world. We had just descended into the magical town of Darjeeling, nestled in the Himalayas with a drop-dead view. We rented a “previously luxurious” suite – a synonym for “had seen better days” – for the bargain price of $10.

But instead of walking around this fantasy kingdom, I was trotting around to the bathroom. For an entire week. Not fun.

We’ve made great strides in attacking this ogre of a disease. Treatment and prevention are better than ever. Following a few of my tips just might make your next vacation quality time rather than a bathroom blitz.

The first thing to remember is prevention, prevention, prevention.

Let’s tackle drinks. No ice, please. Freezing doesn’t kill bacteria, viruses or parasites. If you’re absolutely, positively sure the ice is from a reliable source, like a classy hotel, you might try it – but you’re taking a chance.

Drink only bottled water where you break the seal on a twist cap. Do not accept – I repeat, do not accept – any water where the waiter opens it up.

It might be dirty water. Anyone who has seen the Academy Award-winning film “Slumdog Millionaire” might remember that back-of-the-restaurant scene where they put tap water into the bottle, close it and sell it as fresh. I bet that doesn’t only happen in the movies.

Another move is to buy carbonated drinks, such as Coke. Fizzy stuff is harder to counterfeit, so it’s a safer bet.

When you choose a restaurant, use common sense. You’re not going to see the attention to sanitation we have in the U.S., but some places will be cleaner than others.

After you sit down, pull out one of those dandy pocket-sized hand sanitizers. Clean your hands and your eating utensils. The treasures you just bought at that market are probably not germ-free. And money is one of the dirtiest things you handle in the Third World.

Maybe you’ve decided to go backstage and look at the kitchen. It looks good to you, so you’re going to go for the fresh stuff. But did you check out the cook staff? In the U.S., there are signs in bathrooms everywhere that say “Employees must wash their hands before going back to work.” Think they do that in Costa Rica? I doubt it.

And what about food carts? In Western New York, the Department of Health has your back. In Mexico, it’s a different story. My rule is if there’s no running water, there’s no sanitation.

Now, on to drugs. Some doctors recommend chewing two Pepto-Bismol tablets four times a day. Studies show it does help, but who can take that stuff day in and day out?

Health food manufacturers suggest taking two lactobacillus capsules four times daily. But to keep them potent, these capsules should be kept in a refrigerator (imagine stuffing that in your backpack). And according to consumerlabs.org, the science behind this probiotic for travelers’ diarrhea is scarce.

What about treatment once you’re sick? If it’s mild, an occasional loose stool, I recommend hydrating with bottled water or, better yet, an electrolyte solution. You can buy Pedialyte-type packets at most camping stores. Be sure to match the amount of fluid you take in with the amount that comes out. Don’t get behind.

If you want to take a slow-me-down agent, choose Imodium A-D. But be careful because if you overdo, it can stop you up like a cork.

What about antibiotics? They’re a godsend. If I’d had them in Darjeeling, I might have had a more enjoyable time. Cipro for adults and Azithromycin for children are a must for anyone traipsing around. They won’t cure everything, such as parasites, but they do cure most diarrhea cases, which makes them worth the cost.

My spin: Traveling is an adventure, which Webster’s defines as “an unusual and exciting, typically hazardous experience or activity.” With a few precautions, you can cut down on the hazardous and highlight the exciting.

Dr. Zorba Paster is a family physician, professor, author and broadcast journalist. He hosts a radio call-in show at 3 p.m. Saturdays on WBFO-FM 88.7.